Background: The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by Thrombolysis in Myocardial Infarction (TIMI)-2 flow in the absence of significant large vessel coronary disease. Although clinical and pathological features have been previously described, the underlying pathophysiology has not been fully elucidated. This study investigates the persistence of the phenomenon on serial angiographic studies, coronary hemodynamic findings at rest and during provocative stimuli, and biochemical evidence of inducible myocardial ischemia.
Methods: Twelve patients with CSFP underwent repeat angiography and coronary sinus canulation that allowed for the assessment of coronary blood flow, transmyocardial lactate, and oxygen extraction. Parameters were assessed at rest and during rapid atrial pacing, cold pressor stimulation, and acetylcholine infusion. Angiographic and coronary hemodynamic findings were compared with 47 patients who underwent angiography and 8 patients who were hemodynamic control subjects, respectively.
Results: Persistent TIMI-2 flow was demonstrated with repeat angiography in only 4 of the patients. However, the corrected TIMI frame count remained delayed compared with that in control subjects. Furthermore, resting coronary sinus oxygen saturation was low compared with control subjects (23% +/- 4% vs 31% +/- 4%; P <.01), reflecting an increased basal coronary vasomotor tone. The coronary vasodilatory response to atrial pacing was similar to that in control subjects; however, several patients exhibited abnormal vasomotor responsiveness to cold pressor and acetylcholine stimuli. There was no evidence of nett myocardial lactate production with atrial pacing.
Conclusion: The CSFP is associated with a chronically elevated resting coronary microvascular tone, even when symptoms are relatively quiescent.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/S0002-8703(03)00124-8 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Novel Therapies for Right Ventricular Failure.
Curr Cardiol Rep
January 2025
Pediatric Advanced Heart Failure and Heart Transplant Program, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS, USA.
Purpose Of Review: Traditionally viewed as a passive player in circulation, the right ventricle (RV) has become a pivotal force in hemodynamics. RV failure (RVF) is a recognized complication of primary cardiac and pulmonary vascular disorders and is associated with a poor prognosis. Unlike treatments for left ventricular failure (LVF), strategies such as adrenoceptor signaling inhibition and renin-angiotensin system modulation have shown limited success in RVF.
View Article and Find Full Text PDFPrediction of pre-eclampsia using maternal hemodynamic parameters at 12 + 0 to 15 + 6 weeks.
Ultrasound Obstet Gynecol
January 2025
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China.
Objectives: To compare the maternal hemodynamic profile at 12 + 0 to 15 + 6 weeks' gestation in women who subsequently developed pre-eclampsia (PE) and those who did not, and to assess the screening performance of maternal hemodynamic parameters for PE in combination with the Fetal Medicine Foundation (FMF) triple test, including maternal factors (MF), mean arterial pressure (MAP), uterine artery pulsatility index and placental growth factor.
Methods: This was a prospective case-control study involving Chinese women with a singleton pregnancy who underwent preterm PE screening at 11 + 0 to 13 + 6 weeks' gestation using the FMF triple test, between February 2020 and February 2023. Women identified as being at high risk (≥ 1:100) for preterm PE by the FMF triple test were matched 1:1 with women identified as low risk (< 1:100) for maternal age ± 3 years, maternal weight ± 5 kg and date of screening ± 14 days.
Long-term hemodynamic responses and reverse remodeling after pharmacotherapy in HFpEF versus HFrEF: a systematic review and meta-analysis.
Am J Physiol Heart Circ Physiol
January 2025
Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, The Netherlands.
The acute response to therapeutic afterload reduction differs between heart failure with preserved (HFpEF) versus reduced ejection fraction (HFrEF), with larger left ventricular (LV) stroke work augmentation in HFrEF compared to HFpEF. This may (partially) explain the neutral effect of HFrEF-medication in HFpEF. It is unclear whether such differences in hemodynamic response persist and/or differentially trigger reverse remodeling in case of long-term afterload reduction.
View Article and Find Full Text PDFA Prospective Study on Maximal Oxygen Uptake and Cardiovascular Functions in 12-Year-Old Endurance Athletes and Their Non-Endurance-Trained Peers.
Scand J Med Sci Sports
January 2025
Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway.
The maximal oxygen uptake (V̇O) is typically higher in endurance-trained adolescents than in non-endurance-trained peers. However, the specific mechanisms contributing to this remain unclear, as well as the impact of training during this developmental stage. This study aims to compare V̇O and cardiovascular functions between 12-year-old endurance athletes and non-endurance-trained over a 14-month period.
View Article and Find Full Text PDFIndividualized PEEP titration by lung compliance during one-lung ventilation: a meta-analysis.
Crit Care
January 2025
Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Background: Despite the physiological advantages of positive end-expiratory pressure (PEEP), its optimal utilization during one-lung ventilation (OLV) remains uncertain. We aimed to investigate whether individualized PEEP titration by lung compliance is associated with a reduced risk of postoperative pulmonary complications during OLV.
Methods: We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials until April 1, 2024, to identify published randomized controlled trials that compared individualized PEEP titration by lung compliance with fixed PEEP during OLV.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!